Case 5

• Geneeskunde
• WO
• Studiejaar 3

Autism

What explanatory theory for autism is meant here?: "the (in)ability to understand context/ see the big picture"

1. Executive dysfunction
2. Central coherence theory
3. Theory of mind

Central coherence theory

Central coherence= ability to understand context/ see big picture

Information processing

All information equally important

Consequences

Inability to choose (everything equally good/important)

Social rules applied too literally

Concretism

Remembers details without overview

Symptom: inability to handle multiple tasks at the same time
Which model explains this symptom?

1. Executive dysfunction
2. Central coherence theory
3. Theory of mind

Executive dysfunction

Less working memory

Fewer strategies for planning

Less flexible in thinking process

Consequences

Planning and organising (thinking ahead, creating structure)

Suppressing impulses

Inflexible 

Multiple tasks at same time (serial thinking)

Theory of Mind

Understand other people by ascribing mental states to them

What kind of risk factor is "new unknown (social) situations"?

1. Predisposing
2. Triggering
3. Sustaining

Predisposing

Triggering

- Advanced parental age

- Low birth weight

- Fetal exposure to valproate

- Genetic predisposition

- Chromosomal abnormalities

- Psychological requirements during early development

- New unknown (social) situations)

- Migration, (sexual) abuse, minority, urban upbringing, cannabis/ alcohol use

- Dysfunctional upbringing (e.g. extreme neglect)

Sustaining

- Intelligence (goes together with language development)

What is the approximate prevalence of autism?

1. 0.01%
2. 0.1%
3. 1%
4. 10%

Epidemiology

Prevalence ~ 1%

Sex: ♂ > ♀ (different presentation in girls!)

Age: 2-3 years

x% of people with ASD have at least 1 comorbid mental disorder

1. 10%
2. 20%
3. 50%
4. 70%

Comorbidity

- Intellectual impairment, language disorder

- ADHD, developmental coordination disorder, anxiety disorders, depressive disorders

- Epilepsy, sleep problems, constipation

People with which cluster personality disorder are described as "dramatic, emotional and erratic"?

1. Cluster A
2. Cluster B
3. Cluster C

To what cluster does paranoid personality disorder belong?

1. Cluster A
2. Cluster B
3. Cluster C

Cluster A + psychosis

Paranoid: paranoid delusion

Schizoid: social withdrawal

Schizotypal: ideas of reference, delusional thoughts, bodily illusions, paranoid ideation

Cluster A + autism

Schizoid personality disorder

Withdrawal ~ social deficits

Age of diagnosis

Books: The Rosie Project

Graeme Simsion

Short movie: Mind my mind